Risk factors and microbiological features of surgical site infections

Abstract

Background: Surgical site infections are the infections of the tissues, organs or spaces exposed bysurgeons during the performance of an invasive procedure manifested in the postoperative periodwithin 30 days after a surgical procedure and up to one year if an implant was placed in the patient.SSI is still higher in India as compared to western data leading to increased morbidity and mortality.This study aimed to analyse the factors associated with SSI and its microflora in a tertiary carecentre. Methods: A descriptive cross-sectional study was done for one year in a tertiary care centrein Bareilly, U.P. All the patients who underwent surgeries related to git pathology in the surgerydepartment, either emergency or elective with surgical site infections, were included in this study.Patients less than 18, all cases operated else were, or re-operated were excluded from this study. Alltraumatic abdominal surgeries were also excluded from this study. Results: The present studyrevealed SSI was associated with 82 (9.4%) cases among elective and 80 (21%) in emergencysurgeries. Superficial incision SSI was found to be most common (90 cases), followed by deepincisional SSI (60 patients) and organ/space SSI (12 cases). Minor intestine surgeries were mostcommonly associated with SSI. The microbiological organism most widely isolated was E. Coli(41.2%), followed by Staphylococcus aureus (27.5%), Klebsiella (16.5%), group A beta-haemolyticStreptococci (9.1%) and Pseudomonas (5.5%). Conclusions: Surgical site infection still causesconsiderable morbidity and high cost to the health care system and is becoming increasingly crucialin medico-legal aspects. Prevention of SSI requires a targeted approach to improve health careworkers' knowledge, practising the guidelines strictly regarding asepsis and optimising the patientbefore surgery. Reduction in rate of SSI will improve cosmesis and make the results of operationsbetter as a whole.